Why do so many German doctors practise homeopathy?

PublishedWednesday 21 November 2018

The inventor of homeopathy, Samuel Hahnemann, was a German physician. It is therefore not surprising that homeopathy quickly took hold in Germany. After its initial success, homeopathy’s history turned out to be a bit of a roller coaster. But only recently, a vocal and effective opposition has come to the fore (see my previous post).

Despite the increasing opposition, the advent of EBM, and the much-publicised fact that the best evidence fails to show homeopathy’s effectiveness, there are many doctors who still practice it. According to one website, there are 4330 doctor homeopaths in Germany (plus, of course, almost the same number of Heilpraktiker who also use homeopathy). This figure is, however, out-dated. The German Medical Association told a friend that, at the end of 2017, there were 5612 doctors practising in Germany who hold the additional qualification (‘Zusatz-Weiterbildung’) homeopathy.

That’s a lot, I find.

Why so many?

Whenever I give lectures on the subject, this is the question that comes up with unfailing regularity. Many people who ask would also imply that, if so many doctors use it, homeopathy must be fine, because doctors have studied and know what they are doing.

My answer usually is that the phenomenon is due to many factors:

history,

regulation,

misinformation,

powerful lobby groups,

patient demand,

homeopathy’s image of being gentle, safe and holistic,

patients’ need to believe in something more than ‘just science’,

the fact that most German health insurances reimburse it,

political support,

etc.

But, in fact, the true explanation, as I have learnt recently, might be much simpler and more profane: MONEY!

A German GP gets 4.36 Euros for taking a conventional history.

If he is a homeopath taking an initial homeopathic history, (s)he gets 130 € according to the ‘Selektivvertrag’.

So, yes, doctors have studied and know that the difference between the two amounts is significant.

30 Responses to Why do so many German doctors practise homeopathy?

To say that doctors practice homeopathy because of the money is completely without this important thing called “evidence.” Have you have heard of this word called “evidence”? You should look it up…and then, provide “evidence.”

You might find it refreshing.

The support of homeopathy from the German Medical Association

According to a 2010 article in the BMJ (British Medical Journal), an impressive 57% of people in Germany use homeopathic medicines. Surprisingly, some German politicians recently sought to stop governmental reimbursement for homeopathic treatment. Much to the surprise of these politicians, however, the German Medical Association has announced its support for homeopathy and for reimbursement for homeopathic care. https://www.bmj.com/content/341/bmj.c3902

92% of Doctors working with top German football (soccer) teams prescribe homeopathic medicines for the players.

According to Deutsche Welle (a leading mainstream news source in Germany), 92% of doctors who work for the national German football (soccer) team and the top two German football leagues (Bundesliga 1 and 2) use homeopathic remedies to keep their players healthy and fit. The lead researcher, Peter Billigmann, when interviewed by popular German magazine, Der Spiegel, said, “The success stories are impressive…homeopathic substances don’t have any side effects, and we’re on the safe side where doping is concerned.” https://www.dw.com/en/german-soccer-stars-sold-on-homeopathic-remedies/a-3383416

It seems that there are other reasons that doctors use homeopathic medicine and that the German people seek out homeopathic treatment. You might try learning about it rather than providing misinformation.

You are the Donald Trump of medicine where facts don’t seem to matter…

and now you try to teach me about the motivations of German homeopaths!
don’t you think I know a thing or two more about this than you?
did you know, for instance why “the German Medical Association has announced its support for homeopathy and for reimbursement for homeopathic care”?
could it be due to the fact that its president is married to a homeopath?

If the President of the German Medical Association is a HIGHLY respected physician (we CAN assume this) and if he believes strongly in “scientific medicine” and “evidence based medicine” (and we CAN assume this too), then, he must have some strong experience that he TRUSTS from his wife from her experiences with homeopathy.

Like I previously said, you are too much like Donald Trump. You have an “us” and “them.” You trust YOUR experiences but no one else’s. I asked for “evidence” from randomized double-blind and placebo controlled trials, and you have not produced any. You simply expressed shock that I would ask for “evidence.” The suggestion that you provided via Google did NOT produce the evidence you promised (and you KNEW this!).

As for the German football players…these are super-star athletes who perform at the TOP of their game and who REQUIRE the best results possible. Please explain why so many of their doctors consider the use of homeopathic medicines ESSENTIAL to these sports superstars?

Mr. Ullman:
You say:“If the President of the German Medical Association is a HIGHLY respected physician (we CAN assume this) and if he believes strongly in “scientific medicine” and “evidence based medicine” (and we CAN assume this too), then, he must have some strong experience that he TRUSTS from his wife from her experiences with homeopathy.”

Mr. Ullman, observations and assumptions like these do not qualify as evidence (not even CIRCUMSTANCIAL evidence, let alone DIRECT evidence).

Another quote from Wiki: “Circumstantial evidence is evidence that relies on an inference to connect it to a conclusion of fact—such as a fingerprint at the scene of a crime. By contrast, direct evidence supports the truth of an assertion directly—i.e., without need for any additional evidence or inference. On its own, circumstantial evidence allows for more than one explanation.”

Thank you for explaining on what “evidence” base you form an opinion… you do not need direct evidence, not even circumstantial evidence, apparently hearsay and assumptions is all you need.
Please stop lecturing us about “evidence”.

Surely, that must come as a surprise to him. Maybe he and his fellow charlatans should learn that capitalisation and exclamation marks are an almost failproof sign that the message is not worth reading.

Where did you ask for evidence from DBRCCTs? Wasn’t that in a previous thread? Involving surgery? It’s something you’ve asked many times and your errors in asking for such evidence in such cases has been explained to you many times. You’ve either failed to understand this, forgotten this or, more likely, deliberately chosen to ignore this because it demonstrates once again your complete stupidity.

Carry on posting your rubbish, Dana. Your posts are useful as exercises for my 11 y/o son and his friends as I teach them about logical fallacies.

Mr. Ullmann:
you bragging about your knowledge of “evidence” on this blog reminds me of a wrong-way driver, claiming that every car coming in your direction is on the wrong track.
This is because when you use this term, you obviously do not use it in the way we are used to use it when discussing medical treatments, i.e. in the scientific sense.

Quote from wiki:
“Scientific evidence consists of observations and experimental results that serve to support, refute, or modify a scientific hypothesis or theory, when collected and interpreted in accordance with the scientific method.”

In this sense, ANECDOTES (e.g. from soccer players or their doctors) are not EVIDENCE. You have been told this over and over on this blog, but do not seem to understand it.

Since you probably do not talk about SCIENTIFIC evidence when you use this term, could you please define what YOU mean when you talk about evidence and how this relates to medical treatments?

Football? Many medicines are on the WADA Prohibited Substances list. FIFA uses that list in its anti-doping regulations. Whilst Therapeutic Use Exemptions applications can be made, they can’t really be justified for minor self-limiting conditions and so on. Sports medicine/physiotherapy is full of all sorts of quackery – but there is an element of psychology involved. It’s not just placebo (which can be highly theatrical), it’s also the lucky talisman thing. Dumbo and his magic feather.

Professional sport is so removed from the everyday world, it’s a very poor justification/comparator.

Any German doctor who does not take a ‘homeopathic history’ is looking at a gift horse in the mouth and we are entitled to question that doctor’s sense of priorities. “First, do no harm – to one’s own position.”
It is a matter for the German regulatory authorities to prevent this abuse, but as long as they are content…

And as long as the doctor only takes a history, and concludes, “There is no homeopathic remedy which will help you, so I will not provide one”, that seems ethical.

Of course, before starting, the doctor must obtain properly informed consent (I assume German ethics on this point are as in UK):
“I am going to question you about your health in a system devised 250 years ago by a Doctor Hahnemann, and which might suggest certain ‘homeopathic remedies’ are indicated. I must tell you there is no plausible reproducible evidence those remedies will provide benefit. Because I will spend 40 minutes with you taking your medical history according to homeopathic principles, you might better come to terms with your condition and so our consultation might benefit you. If you are content to proceed with that understanding, let us start…”.

For people who claim to want “evidence,” it is remarkable how much the people here mis-use information.

A homeopathic consultation is usually one-hour (or more)…while the average conventional MD visit is around 5-10 minutes…and as for the costs, conventional MDs require a long list of often expensive laboratory reports, none of which are required for a homeopathic prescription.

So, homeos spend an hour with a patient, listening intently (I’m sure) and then give them a “treatment” that does nothing. For that, they charge 180 Euro? Nice.

You wrote, “and as for the costs, conventional MDs require a long list of often expensive laboratory reports, none of which are required for a homeopathic prescription.” What does that have to do with the cost of taking a history? Because lab reports are expensive, the consultation should be cheap? Makes no sense, Dana.

What “name” did I call you? I wrote that you were “confused.” THAT is not name-calling.

As for name-calling, you called me a “homeopathic apologist.” You skeptics are too much like Donald Trump. You project your own deficiencies onto others. You provide a classic case of this…and this simply proves your own intellectual dishonesty (this is not “name-calling”; it is a description of a behavor…big diff). Are you even dyeing your hair orange?

In his book “Homeopathy, Medicine for the 21st Century”, Ulman claims that homeopathic remedies have been successful in treating AIDS, herpes, influenza, bladder and ear infections, meningitis, plague, cholera, scarlet fever, yellow fever, typhoid and strep throat. He predicts homeopathic remedies will largely replace antibiotics. He says it is not so important to know what microorganism has infected a person as it is to know what kind of woman the microorganism has infected. For example, a sepia woman is one whose constitutional medicine is homeopathically prepared cuttlefish. She is overworked, assertive, outspoken, irritable, quarrelsome, sexually frigid, and has low thyroid hormone levels, low blood pressure and adrenal insufficiency. Also, he says that a correctly prescribed homeopathic remedy tends to work immediately, but elsewhere says after the remedy is given the patient commonly gets worse before getting better — the homeopathic “healing crisis.” One of the products he peddles is a “homeopathic tranquilizer” containing passion flower, hops and chamomile. Herbalists consider these to be tranquilizers in normal doses, so they should be stimulants in homeopathic doses. When I asked him about this, instead of explaining himself he threatened to sue me. For much more on this as well as naturopathy, Chiropractic and other trendy systems see my book, “A Consumer’s Guide to ‘Alternative Medicine'” published by Prometheus Books and edited by venerable quack buster Stephen Barrett, MD.

I was not aware that the traits of an infected person are more important than the characteristics of the pathogenic microbe when treating a microbial infection!

This is very embarrassing for me, since I just finished a beginner’s course on microbiology with 300 students and –because of my ignorance- did not tell them about the important findings from Mr. Ullman! I just taught them about outdated concepts like e.g. pathogenic microorganisms, toxins, molecule structures, and protein-, nucleic acid- or cell wall synthesis inhibitors.
I also told the students about the tremendous difficulties of finding new antibiotics against multi-resistant bacteria and new strategies to achieve this goal today. Shame on me, there´s no way around it, I have to take responsibility that I did not even know that homeopathic remedies will soon replace antibiotics, solving this problem once and for all!

I’m unfamiliar with the detail of how healthcare works in Germany or the behaviour of German consumers. Whilst I’ve been to Germany numerous times, never had the misfortune to suffer anything other than minor self-limiting conditions.

Something I have noticed in my travels is that different countries can have very different “folk medicine”/self-care traditions. To a degree what is available as OTC in pharmacies and retail outlets is influenced by that. It could also be argued that proprietary OTC medicines have also become part of “folk medicine” – would qv irrational brand loyalty to useless overpriced cough mixtures, etc. And from observation, this can be a family thing. Granny used it, so mother used it, so I use it on myself and the children. Even with effective products, brand loyalty exists and some consumers will swear by branded products and claim generics not as effective etc. Personally, I resent paying a massive premium for branded paracetamol and ibuprofen but others don’t.

Do Germans visit the doctor more often that other EU nations? Do they visit the doctor for more minor conditions? Is there a greater expectation that a visit to the doctor necessarily results in a prescription of something?

I suspect cultural differences can be much greater than initially thought.

Ullman says his book “Homeopathy, Medicine for the 21st Century” “synthesizes homeopathy, Jungian psychology, alchemy and the new physics.” This kind of grandiosity reminds me of Deepak Chopra. The book claims homeopathy is effective for practically every disease known to humans, yet it presents only a handful of questionable studies to support the use of a half dozen remedies in a few self-limiting conditions. Ullman typifies the combination of fuzzy thinking and messianic attitude characteristic of religiously-zealous homeopaths. It’s a pity rationalists have to spend so much time refuting such obviously preposterous nonsense. Most people who become quackery practitioners do so because they want to be physicians but lack the aptitude and stamina to get through medical school. So they get into fringe healing cults that foster their delusions and allow them to feel powerful and proud